225 resultados para Erro clínico


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Introduction: Equine therapy is a therapy that uses horses to provide the practitioner in rehabilitation aspects of motor, sensory, behavioral and social. Objective: To investigate the effect of the combination of playful activities with hippotherapy sessions on the trunk balance and range of motion. Methods: We selected 18 practitioners diagnosed with cerebral palsy were randomly divided into two groups. The group 1 held hippotherapy sessions, and group 2 held equine therapy with recreational activities and sports. Before and after treatment, the trunk control and range of motion of the practitioners were evaluated. The data were analyzed using the Student’s t-test (p <0.05). Results: There was an improvement in range of motion and balance in both groups. Conclusion: Equine therapy is an effective treatment for individuals with cerebral palsy, regardless of accomplishing it with or without recreational activities.

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Protrusion of the intervertebral disc can cause chronic progressive compression of the spinal cord, and the neurological associated signs vary according to anatomical location, duration and dynamic force of compression. The type II disc disease is not fully understood, and there are many controversies about is clinical significance and best form of treatment. The most important aspect of conservative treatment is rest and physiotherapy associated with mild exercise, and use of corticosteroids to reduce vasogenic edema. The spinal decompression by surgery for removal of disc material from within the medullary canal is the surgical treatment of choice in type I disc disease, but has technical limitations in the type II disc disease. The purpose of this paper is to review the pathophysiology and treatment of chronic intervertebral disc disease and discuss the controversies in medical treatment and the use of some traditional and new surgical techniques.

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The urbanization process established in Brazilian society since the middle of last century brought changes in the population habits and customs, which was responsible for the increased of chronic diseases incidence, such as arterial hypertension, for example. Although this is a common disease nowadays, it is still difficult to establish a significant control in subjects with this disease and its consequences. This is apparently due to lack of interest to the correct plan of care developed for the treatment of this disease. The nursing consultation identifies potential problematic situations and the patient needs, setting actions that are complementary to their benefit in order to promote health. The present work aims to observe how the nursing consultation is being used as strategy for patients with arterial hypertension, and to understand the difficulties faced during treatment of these patients. For this purpose, it was performed qualitative and quantitative studies with patients from Centro Saúde Escola (CSE), Unidade Auxiliar, Faculdade de Medicina de Botucatu, UNESP, located in Botucatu, employing as methodology the Discourse of the Collective Subject and descriptive statistical analysis of quantitative results. The vast majority of consultations were held by medical professionals and it was observed that the multidisciplinary work still needs to be recognized and valued by users. The lack of knowledge of some individuals in relation to the potential and importance of the nursing consultation occurs not only for the treatment of arterial hypertension, but for the treatment and monitoring of the individual as a whole. Therefore, it is still necessary to clarify the true essence and necessity of the nursing consultation, since so important tool should be used in its entirely. Moreover, the role of the multidisciplinary team should be more discussed

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Due to the complexity and instability of clinical conditions of ICU patients, the drug therapy applied in this type of environment requires a combination of several prescribed drugs, which is a favorable condition for drug interaction, toxic synergism and possible iatrogenia. In the possible universe of ICU occurrences, this study aimed at identifying and evaluating the incidence of adverse events in drug therapy at the Intensive Care Therapy Service (SETI) in wards I and II. It is a cross-sectional, descriptive, prospective and quantitative study conducted from August to September, 2011 in the Intensive Care Service of the Botucatu School of Medicine University Hospital - UNESP. The population consisted of fifteen clinical nurses, including those in the Improvement and Volunteer Internship Programs, who contributed to the investigation after signing an informed consent form and according to approval by the Research Ethics Committee number 10711/CE - FMB. The data were entered on a form and analyzed. Results showed that, on average, 8.9% of events/day occurred, and the highest frequency was observed on August 04, 2011. 63% and 22% were respectively observed in the morning and afternoon shifts, and 15% in the night shift. 48% of these were due to administration time errors, followed by drug prescription and dispensation errors, with percentages of 22% and 18%, respectively. Antibiotics showed the highest frequency of adverse events - 18%, which was followed by 13% for anticoagulant, 11% for antiemetic and 10% for antiulcerative drugs. As regards the occurrence of adverse events related to hospitalization time, the highest frequency occurred in patients who were hospitalized for 10 days. Concerning the ratio between reported events and the number of items in the prescription, the highest frequency of events was related to prescriptions with 20 items... (Complete abstract click electronic access below)

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GOALS: This research evaluated the change in arterial pressure before and after two procedures of dental prophylaxis: Jet system baking soda and conventional prophylaxis and patient's opinion regarding the comfort of each one. MATERIAL AND METHOD: Were selected 32 patients with age between 18 to 30 years old, who need prophylaxis to remove biofilm and were subjected to three different types of treatment: sodium bicarbonate jet (G1), prophylaxis conventional (G2) and placebo (G3) at intervals of one month between them. Patients were divided randomly. Arterial pressure was measured by wrist digital Omron HEM – 6111. The measurements were realized in four times: before the prophylaxis, immediately the end of procedure, 15 and 30 minutes after finished of treatment. Patient comfort was measured by a Visual Analog Scale (VAS) after the end of the treatment. The data were analyzed using the variance test. The results showed that there was statistically significant difference to the comfort of the procedures. RESULTS: There was a statistically significant difference to the comfort of the procedures, and G2 and G3 better than G1. Regarding the variation of arterial pressure there was no statistically significant difference between groups. CONCLUSIONS: The methods of prophylaxis no effect on arterial pressure, but conventional prophylaxis is more comfortable than others treatments

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Oncology is presenting an important role in clinical practice as a speciality in recent years in Veterinary Medicine. Mammary gland tumors are detected mainly in old and middleaged bitches that are sexually intact or spayed and the caudal abdominal and inguinal mammary glands are the most affected and they present a percentage up to 75% of malignancy. The majority of dogs with mammary neoplasms are clinically healthy at the time of diagnosis and the tumors can be identified by the owner or a professional during a routine physical examination. Cytological examination of fine needle aspirates can be performed. This procedure is easy and low cost and some criteria that may indicate malignancy are evaluated, however to obtain a definitive diagnosis is performed histopathology of the excised tissue or from biopsy. Regional lymph nodes are the first lymph node to receive lymphatic drainage from the neoplasm. They are at the highest risk of regional metastasis, while the lung is the most common site for distant metastasis. Determining the clinical stage enables the definition of the extension of the tumor. As a consequence, this allows a prognosis to be established and treatment to be planned. The type of therapy to be chosen incites controversy since there are numerous treatment options described, but the surgery is the chosen treatment. However, surgery is not always effective for malignant tumors, and recurrences may occur and in these cases, auxiliary chemotherapy treatments are used. The prognosis for animals that have mammary tumors depends on several factors, such as: size, stage, type of tumor cells and clinical behavior of the tumor, age and medical condition of the animal, and presence of metastasis. Because of this, more detailed studies are needed based on epidemiological surveys in order to provide more informations about risk factors, prevalence and follow-up after treatment of mammary... (Complete abstract click electronic access below)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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In malocclusion studies, may happen not only dental discrepancies but even skeletal discrepancies. In Class III malocclusion can be observed underdeveloped maxilla, mandible protraction or both of them, and, in most of the times associated with a narrow maxilla that causes anterior or posterior crossbites, in one side or in two sides. The aim of this case report is to evaluate the facial profile and occlusal effects of interceptive orthodontics therapy. The treatment with upper arch expansion and maxilla protraction was done in an early age to be effective in the circummaxillary sutural system and to make the orthopedic effect easier. The facial mask used is positioned on two facial points and allows an anterior maxillary replacement. Patients’ compliance is important to reach treatment success, this because using the mask still in this growth and development phase is essential to make the facial and occlusal effects happen. It is important to mention that patients with Angle Class III malocclusion need to be followed till the end of their growth.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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The pattern of caries lesions has been modified over decades. If the presence or absence of a caries lesion is based upon only a visual examination, its diagnosis might become underestimated since dentinal lesions underneath non cavitated or minimally demineralized enamel is highly frequent in dental clinics. The aim of this paper is to report a clinical case of a child with an upper molar with questionable occlusal aspect, presenting asymptomatic pulpal hyperplasia on the distolingual pit. Periapical radiographic examination was essential for diagnosing hidden caries and elaborating the treatment plan. As part of the approach, removal of the decayed tissue and pulpotomy with calcium hydroxide were performed. The association of an accurate visual examination to an adequate oral radiographyis is extremely important in cases which the presence of hidden caries is doubtful. As a result, an early diagnosis and the reduction of more invasive interventions related to the oral health care of pediatric patients can be achieved as well.

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The bone resorption in the anterior maxilla, due to its aesthetic importance, can be considered one of the challenges in implant dentistry. Autogenous bone graft is the most indicated bone augmentation procedure, aiming an implant supported rehabilitation.. Alternatively, some other graft procedures can be done with homogenous and xenogenous bone graft, biomaterials and different associations. Additionally to the mentioned biomaterials, the bone morphogenetic protein (BMP), specially the rhBMP-2, which was characterized as a bone osteoinductor, and consecutively, a potential autogenous graft substitute, with previsibility and no necessity of association to other biomaterial. The objective of this study is to present a single case using the rhBMP-2 for bone augmentation.